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An alternative way to stem sick leave (ab)use in Malta?

Training managers to identify symptoms of mental stress may help their employees and potentially reduce sick leave. Photo: Shutterstock.com

Training managers to care for the mental well-being of their staff could be an effective way for companies to reduce the burden of sick leave costs, according to a recent study in Australia reported in medical journal The Lancet Psychiatry.

Sick leave recently hit local headlines when, as part of its Budget proposals, the Malta Employers’ Association suggested that that the first day of sick leave should be unpaid, as happens in some other countries, as a way of deterring abuse and cutting the cost of sick leave for employers.

Malta Employers’ Association director general Joe Farrugia: “It is difficult for micro-enterprises, which make up the vast majority of local enterprises, to have resources for such training.”

However, the trade unions immediately poured cold water on the proposal, with Prime Minister Joseph Muscat describing it as “a non-starter” in comments given to this newspaper.

The Australian study involved a four-hour training progamme for managers on how to recognise symptoms of depression, anxiety, post-traumatic stress and alcohol misuse in the workplace. The programme underwent a trial in 2014 among 128 managers at the Fire and Rescue New South Wales, the seventh largest urban fire service in the world.

Six months after the training the researchers followed-up all the managers, analysing changes in sick leave use among the 2,000 fire-fighters and station officers supervised by the study participants.

Among employees of managers who had undergone the training, the average rate of work-related sick leave dropped by 0.28 of a percentage point, from 1.56 per cent to 1.28 per cent, corresponding to a reduction of nearly 6.5 hours per employee over the six months.

By comparison, the rate of work-related sick leave among staff of managers who had not undergone the training increased by 0.28 of a percentage point, from 0.95 per cent to 1.23 per cent, during the same period. Average rates of standard sick leave increased in both groups by about one-third to half of a percentage point, from roughly five per cent.

The total cost of the training programme was about €650 per manager, and based on the firefighters’ hourly wage, the researchers calculated the re­duction in work-related sickness absences associated with training had saved €6,490 in costs per manager.

This equates to a roughly 10-to-one return on investment.

Asked whether such a programme could be an alternative ‘carrot’ to stem sick leave (ab)use, compared to the ‘stick’ proposed by his association, Malta Employers’ Association director general Joe Farrugia said: “Any training that improves managerial performance is something to be recommended, but it should be left up to individual companies to decide whether to train its personnel in this area or not, and the form of training that should be provided.”

He added that many companies in Malta, especially the larger ones that have an established human resources function, al­ready train managers in the promotion of mental health, and the MEA has organised courses in mental health for its members in the past few years.

However, he cautioned that “it is more difficult for micro-enterprises, which make up the vast majority of our enterprises, to have resources for such training, especially since the manager is frequently the owner of the business”.

Mr Farrugia said that training on this issue should focus on prevention, where possible, together with knowledge, control and discipline.

“Managers should be trained to identify symptoms in certain cases. For instance, mental health issues could manifest themselves in sudden shifts in performance that do not warrant disciplinary action.”

The return on investment creates a real incentive to get workplaces involved in mental health

One major challenge, he pointed out, is to determine whether the symptoms arise from work-related issues or are externally generated. “An em­ployee may be suffering from mental stress due to bullying at the workplace – which can and should be tackled by management – or else due to problems outside the workplace, which can range from gambling debts to the death of a close family member.

“Training managers to identify such symptoms may help the employee concerned and potentially reduce sick leave.

“Managers can also be trained to identify abusers through numerous techniques, such as monitoring patterns of sick leave, liaising with the company doctor where possible,” he added.

“In some cases, even the source or reason of the abuse needs investigation,” Mr Farrugia explained.

“In some sections of the public sector, for instance, employees may be encouraged to abuse sick leave because they are underutilised or sidelined, or have suffered from injustices in promotions, or even lack of empowerment.”

Notwithstanding the mutual benefits of such training for companies and staff alike, Mr Farrugia still believes Malta has a problem where sick leave abuse is concerned.

“We need to be more vigilant on the manner in which sick leave is availed of,” he said. “It is very easy to obtain sick leave certificates in Malta. Official figures show that public sector employees take three times more sick leave than those in the private sector, where only a minority abuse of sick leave on a regular basis.”

He said cost of this abuse “is carried by companies in terms of lost production and by honest employees who have to make up for the absences of abusers through an added workload and unwanted overtime”.

Having said this, Mr Farrugia stressed that employers agreed that staff should use sick leave under the proper circumstances, adding that many companies in Malta go out of their way and extend such benefits in cases of serious illness.

Writing in an article accompanying the report on the Australian study, John Greden of the University of Michigan’s Comprehensive Depression Centre, who is studying the most effective training programmes and how to tailor them to different workplace settings, said: “If you want to make a difference in the workplace, you have to talk about profit. The return on investment creates a real incentive to get workplaces involved in mental health.”

In a follow-up phone interview with Reuters Health, Dr Greden added: “Society can reinforce these efforts, or we can continue paying a high price with the disruption of families through divorce, the loss of jobs and suicide. The better approach is to take on these issues and incorporate them into our workplace.

“Supervisors can be allies who help their employees get assistance,” he said. “It’s a commonsense approach to talk to the people you’re supervising and ask how they’re doing.”

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